We are currently conducting a study (Neonatal Neurobehavior and Outcomes in Very Preterm Infants, 1R01HD072267-01A1) of infants born <30 weeks postmenstrual age (PMA). These infants experience potentially devastating brain injuries associated with immaturity, hypoxic insults, and inflammatory exposures and are at high risk for developing neuromotor, cognitive, and behavioral impairments that persist through adulthood. However, for the majority of infants, there is no reliable method during their stay in the Neonatal Intensive Care Unit (NICU) to distinguish infants who will go on to develop later impairments from those who will not. The goal of the parent grant is to determine which infants born <30 weeks PMA are at greatest risk for impaired development using a neurobehavioral assessment (the NICU Network Neurobehavioral Scale or NNNS) and a medical risk score. In this proposed study, we have added an objective that enhances and is within the scope of the parent grant; the study of epigenetic markers that regulate gene expression and could suggest molecular mechanisms involved in our study findings. We are collecting cheek swabs shortly before discharge from the NICU and at the 24-month outcome visit to be used for the epigenetic analysis. The epigenetic measures were not included in the parent grant because the cost to cover the analysis of these data was prohibitive. This application is a request for funds for the analysis of the epigenetic data already being collected in the parent grant. The addition of epigenetics is potentially of great importance and highly likely to increase the impact of the study.